SIR 2024
Venous Interventions
Varun Danda, MD (he/him/his)
Interventional Radiology Resident
Icahn School of Medicine at Mount Sinai
Financial relationships: Full list of relationships is listed on the CME information page.
Daryl Goldman, MD
Resident
Icahn School of Medicine at Mount Sinai
Disclosure information not submitted.
Vivian Bishay, MD
IR
Mount Sinai Hospital System
Financial relationships: Full list of relationships is listed on the CME information page.
Dan Shilo, MD
Assistant Professor, Diagnostic, Molecular and Interventional Radiology
Mount Sinai Hospital
Disclosure information not submitted.
Kirema Garcia-Reyes, MD
Assistant Professor
Mount Sinai
Financial relationships: Full list of relationships is listed on the CME information page.
Jenanan Vairavamurthy, MD
Assistant Professor, Interventional Radiologist
Keck School of Medicine, Univeristy of Southern California
Disclosure information not submitted.
Rahul S. Patel, MD
Assistant Professor, Diagnostic, Molecular and Interventional Radiology
Mount Sinai Medical Center\n
Financial relationships: Full list of relationships is listed on the CME information page.
Edward Kim, MD (he/him/his)
Professor of Radiology
Mount Sinai Health System
Financial relationships: Full list of relationships is listed on the CME information page.
Rajesh I. Patel, MD
Assistant Professor, Diagnostic, Molecular and Interventional Radiology
Mount Sinai Hospital
Disclosure information not submitted.
Aaron M. Fischman, MD, FSIR, FCIRSE, FSVM
Professor, Diagnostic, Molecular and Interventional Radiology
Icahn School of Medicine at Mount Sinai
Disclosure information not submitted.
Robert A. Lookstein, MD
Executive Vice Chair; Diagnostic, Molecular, and Interventional Radiology
Mount Sinai Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
In recent years, the arsenal of endovascular devices to treat pulmonary embolism (PE) has significantly expanded. This study presents our initial experience with the 16F Lightning Flash mechanical thrombectomy system (Penumbra Inc., Alameda, CA, USA) in the management of intermediate-high risk and high-risk PE.
Materials and Methods:
A retrospective, single-center study was performed on patients diagnosed with acute intermediate-high and high risk PE who underwent mechanical thrombectomy using the 16F Lightning Flash device between January 2023 and September 2023. Clinical and technical parameters were assessed during hospitalization. Paired t-test and interquartile range calculations were used for statistical analysis.
Results:
Twelve patients were treated with 16F Lightning Flash thrombectomy device with a median (IQR) age of 63 (54-70) years, 75% male. 11 patients were diagnosed with intermediate-high risk PE and 1 patient was diagnosed with high risk PE. The mean fluoroscopic time was 21.8 (14.4 - 23.7) minutes. Technical success was achieved in 100% patients and mean main pulmonary artery (PA) pressure decreased significantly from 24.5 mmHg to 16.8 mmHg (p=0.0009). Selective PA pressures significantly decreased from 26.3 mmHg to 19.1 mmHg (p=0.005). No device-related or procedural complications were observed in this cohort. One patient death occurred on post-op day 17 related to multifactorial shock secondary to pre-existing comorbidities. Estimated blood loss was 228 (10 - 380) cc. Mean preprocedural hemoglobin levels were 12.0 (10.3 - 13.4) g/dL, which decreased to 11.0 (9.0 - 12.2) g/dL on post-op day 1 (p=0.008) and 10.5 (9.4 - 11.5) g/dL on day of discharge (p=0.004). The mean postprocedural length of stay was 3.3 (3-4) days.
Conclusion:
Our experience with the Lightning Flash device for treating PE demonstrates promising results. In this cohort, the device was safe and effective, characterized by a 100% technical and clinical success rate, and favorable early clinical outcomes.